Maternal Diarrhea During the Periconceptional Period and the Risk of Birth Defects, National Birth Defects Prevention Study, 2006–2011

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2025-02-20 DOI:10.1002/bdr2.2438

Dorothy Kim Waller, Nithya Lakshmi Mohan Dass, Omobola O. Oluwafemi, A. J. Agopian, Ji Yun Tark, Adrienne T. Hoyt, Angela E. Scheuerle, Mark A. Canfield, the National Birth Defects Prevention Study

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Abstract

Background

The primary objective of this study was to assess associations between maternal reports of diarrhea during early pregnancy and a range of different birth defects, most of which have not been assessed in previous studies. The secondary objective was to determine whether associations were modified by maternal use of multivitamins.

Methods

We analyzed data on 16,675 mothers who participated in the National Birth Defects Prevention Study (NBDPS) and delivered between 2006 and 2011. Logistic regression was used to evaluate associations between maternal report of diarrhea during the periconceptional period and 32 categories of birth defects. Odds ratios were adjusted for nine covariates.

Results

Eleven percent of women reported having diarrhea during the periconceptional period. We observed elevated associations (p < 0.10) between maternal report of diarrhea lasting 1–5 days and 9 of 32 independent categories of birth defects (hypoplastic left heart, muscular ventricular septal defect, single ventricle complex, secundum atrial septal defect, esophageal atresia, diaphragmatic hernia, omphalocele, gastroschisis, and amniotic band syndrome). The elevated adjusted odds ratios (aORs) ranged from 1.45 to 2.62. There were no decreased associations between maternal report of diarrhea lasting 1–5 days and any of the 32 birth defects. There was no evidence for a significant linear trend of stronger associations between maternal diarrhea and birth defects among mothers who had inadequate or suboptimal use of multivitamins.

Conclusion

Our results are consistent with modest associations between shorter, but not longer, bouts of maternal diarrhea and specific categories of birth defects. These results add to existing evidence, suggesting maternal diarrhea and gastrointestinal infections during early pregnancy are associated with a higher frequency of some birth defects.

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妊娠期产妇腹泻与出生缺陷风险调查，2006-2011年全国出生缺陷预防研究

本研究的主要目的是评估孕妇报告的妊娠早期腹泻与一系列不同的出生缺陷之间的关系，其中大多数在以前的研究中没有被评估过。次要目的是确定这种关联是否因母亲使用多种维生素而改变。方法我们分析了2006年至2011年间参加国家出生缺陷预防研究（NBDPS）并分娩的16,675名母亲的数据。采用Logistic回归评价围孕期产妇报告腹泻与32种出生缺陷之间的关系。校正了9个协变量的优势比。结果11%的妇女报告在围孕期有腹泻。我们观察到孕妇报告持续1-5天的腹泻与32种独立出生缺陷（左心发育不全、肌性室间隔缺损、单心室复合症、第二房间隔缺损、食管闭锁、膈疝、脐膨出、胃裂和羊膜带综合征）中的9种存在较高的相关性（p < 0.10）。升高的校正优势比（aORs）范围为1.45 ~ 2.62。产妇报告持续1-5天的腹泻与32种出生缺陷中的任何一种之间没有减少的关联。没有证据表明，在复合维生素使用不足或不理想的母亲中，母亲腹泻和出生缺陷之间存在显著的线性趋势。结论：我们的研究结果与短时间（而不是长时间）母体腹泻发作与特定类型的出生缺陷之间的适度关联是一致的。这些结果增加了现有的证据，表明怀孕早期产妇腹泻和胃肠道感染与某些出生缺陷的高频率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.